A Call to Action: Increasing Physical Activity in Arthritis
"Arthritis is a major player in the health tsunami that is coming to America."
- Dr. Patience White, VP of Public Health, The Arthritis Foundation
22.2 percent of Americans over the age of 18 live with one of the over 100 kinds of arthritis. This number represents 50 million people whose lives are affected by these types of diseases. In 2030, 62 million Americans will have arthritis. That's a lot of pain, mobility issues and lost ability to work and participate in the community. The cost of arthritis is greater than what happens in each individual's life. According to the CDC, in 2003 arthritis cost the US economy $128 billion in medical care expenditures and lost earnings. This year, it will cost even more and in 2030, when 62 million Americans will have arthritis, the cost - both individual and social - will be through the roof.
Arthritis is closely connected to the fact that two thirds of the people in the US are overweight or obese. Being overweight carries a higher risk of developing osteoarthritis, as well as other types of weight-related illnesses (comorbidities), such as diabetes and heart disease. One of the major factors in managing these conditions is physical activity, but staying active can be a challenge for people who have arthritis. Joint pain makes it hard to move, sometimes next to impossible. When you do try to move, you realize that in many ways, our world is built for the healthy and ablebodied, making it hard for people with physical limitations to stay active.
The Arthritis Foundation would like to change that. On May 16, 2012, they released a report called Environmental and Policy Strategies to Increase Physical Activity among Adults with Arthritis. This report was completed in cooperation with the Congressional Arthritis Caucus and cosponsored by 25 other organizations, including the American Chronic Pain Association, American College of Sports Medicine, National Recreation and Parks Association and the YMCA of the USA.
To find out more, I spoke to Dr. Patience White, Vice President of Public Health at The Arthritis Foundation.
The report is "a call to action for all to think about this issue," Dr. White says. "Physical activity helps with a number of medical conditions in addition to arthritis and being overweight, including depression and dementia. However, a large number think they can’t do it.” And many may be right. "The environment doesn't make exercise easy," Dr. White points out, "and that means arthritis and its comorbidities (high blood pressure, diabetes and heart disease) get worse." This is not just an individual issue, but also a public health issue, as the cost to our society and health care system increases.
Inspired by the changes in individual and public health brought about by anti-smoking policy, The Arthritis Foundation set about creating a call for action that would "focus on how to live well with arthritis and be productive in society by taking positive action to make it easier to do more." It will do so, Dr. White continued, by "alerting sectors to what they can do to create an environment in which it is easier for people with arthritis to participate." Six sectors were included in the report:
- Community and Public Health
- Health care
- Transportation, Land Use and Community Design
- Business and Industry
- Parks, Recreation, Fitness and Sports
- Mass Media and Communications
The report outlines a number of strategies that the sectors can undertake to ensure it's inclusive of people with arthritis. These strategies build on the Americans with Disabilities Act and other legislation to remove barriers to physical activity, as well as initiate environmental and policy strategies that can help people with mobility issues increase activity. Dr. White explains that "the focus is on how to live well with arthritis and be productive in society."
The top priorities were identified based on initiatives that are practical, doable within a few years and likely to have the most significant impact for adults with arthritis. As the six sectors develop initiatives, the combined impact of changes within each could have a profound impact on the health and wellness of people with arthritis.
For instance, the suggested initiatives for the sectors include health care professionals asking people with arthritis about physical activity at every medical visit (Health care) and referring them to evidence-based physical activity programs in the community (Community and Public Health). Another initiative could be increasing the length of time that the light of a crosswalk is green (Transportation, Land Use and Community Design), allowing people with arthritis to walk across the park, on the other side of the street. At this park, Parks and Recreation staff would have received training in how to make their physical activity programs inclusive of people with mobility issues, as well as more accessible park design (Parks, Recreation, Fitness and Sport). Worksite wellness programs should be designed in such a way that they are inclusive of employees with arthritis (Business and Industry). Mass Media and Communications would engage in outreach, signage and promotion of evidence-based physical activity programs.
There are challenges to implementing the recommendations in the Foundation's report. However, Dr. White emphasized that economically difficult periods are "the time to collaborate and use resources effectively and in new ways." By working together, sectors can support each other's initiatives and do more with less to make it easier for people with arthritis to get physically active. Doing so will have a tremendous impact on the economic health of society, as well as that of individuals with arthritis, enabling them to once again participate and contribute.
A list of evidence-based physical activity programs is available in Appendix B of The Arthritis Foundation report (pdf).
William Carroll, MA and Jeffrey Rhoades, PhD, Statistical Brief #364: Obesity in America: Estimates for the U.S. Civilian Noninstitutionalized Population Age 20 and Older, 2009. Agency for Healthcare Research and Quality, March, 2012.
Don't forget to enter our amazing arthritis awareness contest by May 31, 2012!
Lene is the author of the award-winning blog The Seated View